Indigenous Health Disparities in Australia

This assignment delves into the complex issue of health disparities affecting Indigenous Australians. It examines various factors contributing to these inequities, including social determinants like poverty, discrimination, and limited access to healthcare. The analysis also considers the profound impact of colonization and ongoing systemic racism on Indigenous communities' well-being. The provided references offer insights from academic research and reports highlighting the challenges and advocating for improved health outcomes for Indigenous Australians.

Running head: CULTURAL AND SOCIAL DIVERSITY IN HEALTH CARE
Cultural and social diversity in healthcare
Name of the Student
Name of the University
Author note

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Cultural and historical events greatly influences health migration and incorporating
components of new culture came into origin of a particular culture. The culture and history on
health is vast affecting perceptions of illness, health, death and beliefs about disease causes
helping healthcare professionals to design and tailor diagnosis, and health promotion approaches
(Anderson & Kowal, 2012). Ethnicity and racial differences present a complex structure of
health differences predisposing them to risk factors in every dimension. These differences are
clear as ethnic or racial groups are rooted in complex interlocked factors of socio-economic
status. Risk factors include behavioural risk factors that predispose cultural groups to chronic
disease and subjected to abusive behaviours related to it like substance abuse or violent
behaviour (Spector, 2012). Healthcare behaviour also contribute to risk as health seeking
behaviour, avoidance or utilization of healthcare, doctor-patient relationship and compliance to
medical regimens also give rise to varying health differences. For example, Aboriginals and
Torres Strait Islander and Chinese families in Australia are subjected to certain risk factors due
to current and historical events in Australia with differences in health outcomes that will be
discussed in the following essay. Moreover, the essay will highlight the influence of service care
provision and healthcare policies on health outcomes of these two cultural groups.
Aboriginals and Torres Strait Islanders (ATSI) is the original Australian people that are
unrivalled in the whole world occupying traditional lands through the mainland country. TSI on
the other hand occupies 270 islands running in between Papua New Guinea and Australia. There
are cultural and ethical differences within ATSI societies having own traditions and language
being original custodians of Australia (Garling et al. 2013). On a contrary, Chinese Australians
are the second largest immigrants’ source in Australia after India. During the Australian Gold
Rushes period, Chinese came to Australia shaping and influencing Australian policy for years

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(Pang, Alfrey & Varea, 2016). Racism is one of the main driving factors that affected Australian
Federation. This immigration depicts that there was bimodal distribution of Chinese in Australia
where some tended to face language difficulties and experienced high unemployment rate. In
stark contrast, Few Chinese came as business or professional migrants who brought great wealth
and skills with them. On a contrary, Colonization and assimilation of government into
mainstream Western society has an impact on every aspect of ATSI life including traditional
roles, health, socio-economic conditions, health equity, access to services and culture
(Tousignant & Sioui, 2013). The policies and procedures post- colonization by government
assimilation had contribute to the Aboriginal people marginalization from the mainstream
society having a disruptive and profound impact on their health, access to healthcare services,
socio-economic welfare and culture around the world. This resulted in reduction of Australian
Aboriginal population by 90% between 1788 and 1900 (Haskins & Lowrie, 2014). The above
comparison shows that being the original people in Australia, ASTI faced discrimination and
marginalization post-colonization practiced even today. However, Chinese Australians being
immigrants left a mark on the Australian history changing the phase of present Australian
society.
After the British settlement, there was appearance of European diseases being the
immediate consequence of British colonization like smallpox, chicken pox, measles and
influenza (Greenwood & de Leeuw, 2012). These are infectious disease spread quickly among
the Aboriginal communities on a large scale. Moreover, the nomadic life of Aboriginals was
disrupted as they were driven away from their lands resulting in reduction of access to water
resources and land (Tuck & Yang, 2012). By 1980s, all Aboriginal lands were taken away by
white settlers and already weakened by appearance of new diseases; it reduced the chances for

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ATSI survival. The stolen lands and civilization also contributed to their present health
conditions as compared to non-indigenous population in Australia (Land, 2015). This is evident
in the fact that as per Aboriginals’ cultural beliefs, physical environment in the local area had
been created by actions of spiritual ancestors and losing them had pervasive risks to their health
and wellbeing. Although, colonization affected ASTI, unlike Chinese Australians actively fought
against racism and prejudice and various famous activists like Lowe Kong Meng and Loius Ah
Mouy highlighted various social and economical issues faced by them (van Holst Pellekaan,
2013). They fought against the policy that restricted migration of non-Europeans to Australia and
finally links were strengthened. Despite of the fact Chinese Australians faced socio-economic
disadvantage and diverse origin; they are successful in retaining many of their original cultural
and social beliefs that had not been weakened in Australia (Ang, 2014). The health issues among
ASTI took place post-colonization; however the scenario for the Chinese Australians is quite
different.
At the time of immigration, Chinese Australians were quite healthy and superior to
Aboriginals health due to strict health requirements during migration. However, with time and
increased length of stay, health advantage of Chinese Australians aligned with Aboriginals
facing racism and discrimination. This predisposed Chinese in Australia to greater ill health with
increased rates of chronic conditions and inefficient self-management practices. Discrimination
against Chinese Australians is alarming as compared to Aboriginals who are viewed as visible
minority and permanently marginalized due to recent trends in politics of Australia (Markus,
2013). Chinese working hours, language is different that increase their frustration and sense of
isolation. This contributed to their mental health problems and emotional disturbances affecting
their health and wellbeing. According to a report, Chinese Australians face high shocking rates

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of discrimination as compared to ASTI as much as 90% by university students (Booth, Leigh &
Varganova, 2012). It is quite reasonable to say that Chinese faced racial discrimination post-
immigration indicating mental health issues as top national priority in Australia.
There is present experienced disadvantage as a result of past dispossession and
dislocation impacting their health in every form. Apart from health, Aboriginals also face worst
housing, occupational, lowest educational, economic, legal and social status or any sort of
identifiable sections in the Australian society. The effect of colonization was saddening as they
were subjected to racism and discrimination, shrunken traditional lands by European empires.
Racism tended to neglect the Aboriginals presence or acknowledge their contribution and impact
on Australian society and culture (Herring et al., 2013). This had a serious impact on their health
increasing the risk of mental health problems, illnesses and subjected to substance abuse. Mental
health problems due to discrimination and disruptive behaviour by healthcare professionals
towards Aboriginals and TSI make them hospitalized for behavioural and psychological
disorders or any self-harming behaviour (Parker & Milroy, 2014). Social factors like self-esteem,
racism and family violence affect their emotional and social wellbeing increasing the risk for
behavioural or emotional difficulties. The assimilation of ATSI into the mainstream facilities in
the society can help to mitigate racism and marginalization of this cultural group. Chinese
Australians face high rates of cardiovascular diseases where unhealthy diet and lack of physical
exercise are the biggest risk factors highlighting an important heath issue (Chen et al., 2012). In
the current scenario, Chinese Australians lack seeking of services for mental health needs and
welfare provision lacks in the scenario and left unvoiced in the mainstream society.
Health care policies and service provisions have also contributed to negative health
outcomes for ATSI and Chinese Australians differing on few aspects. ATSI faces cultural

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barriers that contribute to inequality in healthcare services as they are culturally, politically and
socially disadvantaged (Durey, Thompson & Wood, 2012). In spite of consistent efforts, policy
makers and healthcare professionals are unable to bridge the gap in providing the, fair and
equitable services to ATSI. These barriers act as longstanding and challenging issue for
Australian government that need immediate consideration. Ethnic or racial disparities act as a
challenge for healthcare professionals in providing equitable healthcare services to this cultural
group due to distinct culture of ATSI. This cultural group experience bullying, intimidation, fear
and lack of cultural sensitivity that greatly affect their psychological and physical health being
vulnerable to mental health issues (Ferdinand, Paradies & Kelaher, 2013). This affects their
equity of access and structural injustices acting as barriers resulting in stigma, discrimination and
stereotyping experienced by ATSI.
On a contrary, Chinese Australians have migrated to Australia and they are not culturally
dominant are at greater risk for poor health outcomes. Language and access to healthcare
services are some of the major barriers that results in inequality in healthcare (Chalmers et al.,
2014). As Chinese Australians are migrants, it is quite obvious that they would face cultural and
language barriers limiting their access to healthcare services. There is strong relationship
between literacy levels and limited access suggesting need for improved knowledge of accessible
materials and healthcare system for migrant community like Chinese Australians. This situation
greatly depicts that this community is homogenous in attitudes, values and beliefs representing a
range of cultural perspectives and consequences that they face due to undefined cultural views
(Artuso et al., 2013). Chinese culture created a backdrop where their identity forges and requires
careful healthcare planning and delivery.

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Aboriginal and Torres Strait Islander Act 2005 states that ASTI needs to be included
into the mainstream Australian society strengthening social inclusion. This results in poor health
outcomes as a result of poor health assessments, GP management plans, allied and team care
management. There is less vaccination and access to management of chronic diseases for ATSI
results in communicable diseases like hepatitis, tuberculosis, AIDS, infestations and skin
infections (Aspin et al., 2012).
National Health Survey was trying to address their challenges since decades, however
due to low availability of ethnic Chinese doctors’ expertise in Traditional Chinese Medicine
(TCM). This is the reason that there is scare research regarding utilization of health services by
Chinese Australians. They use less public health services and hospitals due to lack of general
Chinese practitioners in the healthcare settings preferring Chinese speaking practitioners. There
is lack of cultural sensitivity in healthcare services with barriers like low use of prevention
services like breast screening and pap smears and insufficient interpreter services. There is also
lack of knowledge about role and existence of ethnic health practitioners that is supported by
racial discrimination against Chinese Australians. Due to low communication, low mental health
literacy, stigma, service constraints and stigma, there is low utilization of healthcare services by
ATSI (Guven & Islam, 2015).
Chinese Australians contributing to their ill health and poor health outcomes. This clearly
depicts that due to economic uncertainty, poor political leadership weakening the parts of Racial
Discrimination Act. This gives rise to a powerful assertion cutting through legalistic debate in
section 18C of the Act that it is highly illegal to intimidate or offend people based on race,
national or ethnic origin or colour (Ford, 2013). This is creating a picture in the country that it is
quite reasonable to become a racist weakening the Anti-Discrimination Act and damaging the

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entire legislation. This high unacceptable level of discrimination and inequality have identified
young Chinese Australians to seek drugs or alcohol and predispose them to high risk of mental
health issues like depression, frustration or stress.
The above difference between the two cultural groups depicts that being the original
population of Australia, ATSI are marginalized and disadvantaged as compared to non-
indigenous population. They face high discrimination and racism in their own country due to
cultural insensitivity towards fulfilling their cultural needs. There is discrimination against ATSI
post-colonization as they are away from mainstream society services although being the original
population of Australia. On a contrary, it is quite obvious that Chinese Australians are
immigrants and face challenges in accessing healthcare services due to language barrier and lack
of Chinese practitioners. There is lack of ethno-specific services that prevent this particular
cultural group from seeking and accessing mental health services and welfare provision fulfilling
their needs.
From the above discussion, it can be concluded that historical and current events greatly
impact health of cultural groups in Australia. Culture and social factors greatly affect health and
perceptions about seeking treatment and diagnosis. Racial differences give rise to health
disparities in the healthcare system where ATSI and Chinese Australians experience inequalities
in healthcare. Due to colonization and stolen lands, ATSI were marginalized and disadvantaged
being deprived of mainstream healthcare services. This had a serious impact on their health
increasing the risk of mental health problems, illnesses and subjected to substance abuse.
Chinese Australians are immigrants who came to Australia during Gold Rush period and face
racial discrimination at alarming rates. This had led to the low access of healthcare services by
these cultural groups due to language barrier and lack of cultural sensitivity. There is need for

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ethno-specific services for these cultural groups to promote social inclusion into mainstream
Australian society.

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References
Anderson, H., & Kowal, E. (2012). Culture, history, and health in an Australian Aboriginal
community: The case of Utopia. Medical anthropology, 31(5), 438-457.
Ang, I. (2014). Beyond Chinese groupism: Chinese Australians between assimilation,
multiculturalism and diaspora. Ethnic and Racial Studies, 37(7), 1184-1196.
Artuso, S., Cargo, M., Brown, A., & Daniel, M. (2013). Factors influencing health care
utilisation among Aboriginal cardiac patients in central Australia: a qualitative
study. BMC Health Services Research, 13(1), 83.
Aspin, C., Brown, N., Jowsey, T., Yen, L., & Leeder, S. (2012). Strategic approaches to
enhanced health service delivery for Aboriginal and Torres Strait Islander people with
chronic illness: a qualitative study. BMC health services research, 12(1), 143.
Booth, A. L., Leigh, A., & Varganova, E. (2012). Does ethnic discrimination vary across
minority groups? Evidence from a field experiment. Oxford Bulletin of Economics and
Statistics, 74(4), 547-573.
Chalmers, K. J., Bond, K. S., Jorm, A. F., Kelly, C. M., Kitchener, B. A., & Williams-Tchen, A.
J. (2014). Providing culturally appropriate mental health first aid to an Aboriginal or
Torres Strait Islander adolescent: development of expert consensus
guidelines. International journal of mental health systems, 8(1), 6.
Chen, K. J., Hui, K. K., Lee, M. S., & Xu, H. (2012). The potential benefit of
complementary/alternative medicine in cardiovascular diseases. Evidence-Based
Complementary and Alternative Medicine, 2012.

10CULTURAL AND SOCIAL DIVERSITY IN HEALTH CARE
Durey, A., Thompson, S. C., & Wood, M. (2012). Time to bring down the twin towers in poor
Aboriginal hospital care: addressing institutional racism and misunderstandings in
communication. Internal medicine journal, 42(1), 17-22.
Ferdinand, A., Paradies, Y., & Kelaher, M. (2013). Mental health impacts of racial
discrimination in Victorian Aboriginal communities. Lowitja Institute.
Ford, M. (2013). Achievement gaps in Australia: What NAPLAN reveals about education
inequality in Australia. Race Ethnicity and Education, 16(1), 80-102.
Garling, S., Hunt, J., Smith, D., & Sanders, W. (2013). Contested governance: culture, power
and institutions in Indigenous Australia (p. 351). ANU Press.
Greenwood, M. L., & de Leeuw, S. N. (2012). Social determinants of health and the future well-
being of Aboriginal children in Canada. Paediatrics & child health, 17(7), 381-384.
Guven, C., & Islam, A. (2015). Age at migration, language proficiency, and socioeconomic
outcomes: evidence from Australia. Demography, 52(2), 513-542.
Haskins, V. K., & Lowrie, C. (Eds.). (2014). Colonization and Domestic Service: Historical and
Contemporary Perspectives(Vol. 14). Routledge.
Herring, S., Spangaro, J., Lauw, M., & McNamara, L. (2013). The intersection of trauma,
racism, and cultural competence in effective work with aboriginal people: Waiting for
trust. Australian Social Work, 66(1), 104-117.
Land, C. (2015). Decolonizing solidarity: Dilemmas and directions for supporters of indigenous
struggles. Zed Books Ltd..

11CULTURAL AND SOCIAL DIVERSITY IN HEALTH CARE
Markus, A. (2013). Australian governments and the concept of race: an historical
perspective. Sydney Studies in Society and Culture, 4.
Pang, B., Alfrey, L., & Varea, V. (2016). Young Chinese Australians' subjectivities of
‘health’and ‘(un) healthy bodies’. Sport, Education and Society, 21(7), 1091-1108.
Parker, R., & Milroy, H. (2014). Aboriginal and Torres Strait Islander mental health: an
overview. Working together: Aboriginal and Torres Strait Islander mental health and
wellbeing principles and practice, 2, 25-38.
Spector, R. E. (2012). Cultural diversity in health and illness. Pearson Higher Ed.
Tousignant, M., & Sioui, N. (2013). Resilience and Aboriginal communities in crisis: Theory
and interventions. International Journal of Indigenous Health, 5(1), 43-61.
Tuck, E., & Yang, K. W. (2012). Decolonization is not a metaphor. Decolonization: Indigeneity,
education & society, 1(1).
van Holst Pellekaan, S. (2013). Genetic evidence for the colonization of Australia. Quaternary
International, 285, 44-56.